Exotropic Drift and Ocular Alignment After Surgical Correction for Intermittent Exotropia

Leow, Po-Lin; Ko, Simon T. C.; Wu, Patrick K. W.; Chan, Clement W. N.
January 2010
Journal of Pediatric Ophthalmology & Strabismus;Jan/Feb2010, Vol. 47 Issue 1, p12
Academic Journal
Purpose: To evaluate changes in the angle of deviation over time and compare the motor success rate with different initial postoperative deviation in patients undergoing surgical correction for intermittent exotropia. Methods: Forty-eight patients aged between 1 and 10 years who underwent bilateral lateral rectus recession for intermittent exotropia were retrospectively evaluated. Preoperative and postoperative ocular deviations at 1 week, 1 month, and 6 months were analyzed. Full surgical correction was attempted in all patients. Motor success was defined as ocular deviation within 10 prism diopters of orthophoria at 6 months postoperatively. Results: The follow-up period ranged from 6 months to 3 years. Although most patients had exotropic drift, this drift was greater in patients with initial esotropia (86.7%) and orthophoria (70.0%) compared to patients with exotropia (26.1%). Motor success was achieved in 29 (60.4%) patients. There was no statistical difference between ocular alignment at 1 week postoperatively and final motor success (P = .782). There was good correlation between ocular alignment at 1 week and 6 months postoperatively (r = 0.585, P < .001). Age and preoperative deviation were not found to be associated with motor success. Conclusions: The success rate appears to be unaffected by initial ocular alignment, suggesting that deliberate initial overcorrection may be unnecessary. Future studies are warranted to evaluate the long-term stability of this alignment.


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